As a young doctor I held the fairly simplistic and conventional view that patients with epilepsy need to start long term treatment with anticonvulsant drugs as soon as the diagnosis is clear. I accepted that epilepsy could not be 'diagnosed after a single seizure but believed that treatment was necessary if a recurrence happened within a year. These views were first challenged for me by a middl...

During a two year period prospective continuous electroencephalographic (EEG) monitoring of 275 infants identified seizure activity in 55 cases, 31 of whom were treated with anticonvulsant drugs on clinical grounds. EEG and clinical response was complete in only two and equivocal in another six. Clinical response with persistent EEG seizures occurred in 13 and neither clinical nor EEG response ...

Anticonvulsant hypersensitivity syndrome (AHS) is a rare, but severe and potentially fatal, adverse reaction that occurs in patients who are treated with commonly used older anticonvulsant drugs (phenytoin, carbamazepine and phenobarbital) and/or with some newer agents (lamotrigine). Paediatric patients are at an increased risk for the development of AHS for the higher incidence of seizure diso...

Newly diagnosed epileptic patients start their medication with monotherapy. Around 30% of epileptic patients require more than one antiepileptic drug. Results from experimental studies provide evidence that administration of two antiepileptic drugs may result in antagonistic, additive, or supra-additive (synergistic) anticonvulsant effects. If adverse effects of a synergistic combination also s...

Clinical and electrical evidence of peripheral neuropathy may result from long term treatment with phenytoin or barbiturates, especially in combination, or after repeated exposure to toxic blood concentrations of either drug. Prolonged acute toxicity with phenytoin may rarely lead to permanent residual ataxia. Reversible dystonia may occasionally be precipitated by phenytoin or carbamazepine; a...

The concept of using SI units has now been accepted in principle by most medical practitioners in the United Kingdom, and laboratories now report most of their results in these units. During the transition period the use of conversion nomograms such as those produced by Baron' and Bold and Wilding2 have proved invaluable in helping both clinician and laboratory worker to adjust to new reference...

1. The absorption of orally administered pteroylmonoglutamate and pteroyltetraglutamate, measured as peak rise in serum folate levels, was examined in normal volunteers and in epileptic patients on anticonvulsant drugs. 2. Although the fasting serum folate levels were low in the patients, they absorbed the two folate forms as well as the volunteers did and there was no difference between the ab...

The question whether antiepileptic drugs alter thyroid function requires a better understanding. In our article, we report two sisters, one of whom was treated with levothyroxine because of hypothyroidism. Although both women received anticonvulsant therapy, transient hypothyroidism was observed only in the hypothyroid woman and was found after treatment with classic anticonvulsant agents (carb...

By disturbing steroid hormone balances in the fetus, the anticonvulsant drugs phenobarbital and phenytoin may affect certain aspects of cognitive functioning. In order to test this hypothesis, we studied hormone related cognitive functioning in 72 men and 75 women who had been prenatally exposed to these drugs and equal numbers of matched control subjects. The groups did not differ on word flue...

Aging is an important biological phenomenon and a major contributor to human disease and disability, but no drugs have been demonstrated to delay human aging. Caenorhabditis elegans is a valuable model for studies of animal aging, and the analysis of drugs that extend the lifespan of this animal can elucidate mechanisms of aging and might lead to treatments for age-related disease. By testing d...